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Updated: Mar 21, 2026
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
MULTICENTRE COMPARISON OF PATIENT AND DETECTOR DOSE FOR X-RAY-GUIDED EMBOLISATIONS OF ARTERIOVENOUS MALFORMATIONS IN
J Geleijns1, M L Overvelde2, D Zweers3
1Department of Radiology, Leiden University Medical Center (LUMC), Albinusdreef 2, 2333 ZA Leiden, The Netherlands j.geleijns@lumc.nl.
This study benchmarked radiation doses for arteriovenous malformation (AVM) treatments. Doses were measured using a head phantom, revealing that current protocols are largely optimized, though minor adjustments could further reduce patient exposure.
Area of Science:
- Medical Physics
- Radiology
- Interventional Neuroradiology
Background:
- Complex neuroradiological procedures, such as treating arteriovenous malformations (AVMs), involve significant radiation exposure.
- Accurate dosimetric benchmarking is crucial for optimizing patient safety in interventional radiology.
Purpose of the Study:
- To benchmark incident entrance dose and dose rate, and entrance detector dose and dose rate for AVM treatment protocols.
- To evaluate current clinical practice for complex neuroradiological AVM treatments across multiple institutions.
Main Methods:
- Utilized a head phantom simulating human head attenuation and scattering for lateral and posteroanterior (PA) views.
- Measured dose and dose rates during fluoroscopy and digital subtraction angiography (DSA) using established clinical protocols.
Main Results:
- Fluoroscopy: Incident entrance dose rate (44-172 μGy/s), entrance detector dose rate (0.3-1.3 μGy/s), pulse rates (6.3-15 fps).
- DSA: Incident entrance dose per frame (744-2800 μGy/frame), entrance detector dose per frame (2.6-8.1 μGy/frame).
- Observed relatively small variations in acquisition parameters across hospitals, indicating a high degree of existing optimization.
Conclusions:
- Current dosimetric protocols for AVM treatment are largely optimized.
- Further minor optimizations in parameters like pulse rate, dose per frame, filtration, and tube voltage may offer additional patient dose reduction.
- The study provides valuable data for quality assurance and protocol refinement in complex X-ray-guided embolizations.
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